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1、双额大骨瓣与双侧标准大骨瓣治疗外伤性急性弥漫性脑肿胀的疗效比较【摘要】目的对比观察双额大骨瓣开颅术与双侧标准大骨瓣开颅术治疗外伤性急性双侧弥漫性脑水肿、脑肿胀合并难治性颅高压的疗效。方法2008年8月〜2011年1月收治的17例患者采取双额大骨瓣开颅手术（A组），2006年6月〜2008年8月收治的31例患者采取双侧标准大骨瓣开颅手术（B组）。观察两组手术时间、失血量、减压窗面积、术中脑膨出率、术后基底池评分、术后并发症发生率及6个月后G0S评估预后。结果A组术中出血量少于B组，手术吋间短于B组,骨窗面积大于B组，差异有统计学意义（PV0.01）,术后基底池评分
2、、术中脑膨出率、术后并发症发生率及预后等比较差异无统计学意义（P>0.05）°结论双额大骨瓣与双侧标准大骨瓣对外伤性急性弥漫性脑肿胀的救治效果相当，但双额大骨瓣创伤小、开颅快速，能有效降低颅内压，值得临床推广。【关键词】双额大骨瓣；双侧标准大骨瓣；平衡减压；弥漫性脑肿胀文章编号:1003-1383（2011）06-0694-03中图分类号：R651.1??+5文献标识码：Adoi:10.3969/j.issn.1003-1383.2011.06.003Thecomparisonofefficacyofthebifrontalbigbonecraniectomya
3、ndthebilateralstandardbigbonecraniectomyinthetreatmentofposttraumaticacutediffuseencephaledemaCUIYonghual、2,XIAYongben??2,ZHANGLiyong??2,CHENHenglin??2,HANQing??2,YURutong??3(1.GraduateFaculty,XuzhouMedicalCollege,Xuzhou,Jiangsu221002；2.NeurosurgeryDepartment,JianhuPeople'sHospital,J
4、ianhuCounty,Jiangsu224700；3.NeurosurgeryDepartment,AffiliatedHospitalofXuzhouMedicalCollege,Xuzhou,.Jiangsu221002)[Abstract]ObjectiveToinvestigatetheefficacyofbifrontalbigbonecraniectomyandbilateralstandardbigboneeraniectomyinbilateralposttraumaticacutediffuseencephaledemaandrefracto
5、ryintracranialhypertensionwithbrainswellingmerger・MethodsThereweretwogroups:GroupAineluded17casestreatedbybifrontalbigbonecraniectomyfromAugustof2008toJanuaryof2011andGroupBincluded31casestreatedbybilateralstandardbigbonecraniectomyfromJuneof2006toAugustof2008・Theoperativeduration,bl
6、oodloss,postoperativereducedpressurewindowarea,intraoperativeencephalocelerates,ratesofpostoperativecomplications,postoperativebasalcisternscoresandtheGOSevaluationprognosis6monthsafteroperationofthetwogroupswererecordedandcompared.ResultsBloodlossofGroupAwaslessthanthatofGroupB.Thes
7、urgicaltimeofGroupAwasshorterthanthatofGroupB.AndthebonewindowareaofGroupAwaslargerthanthatofGroupB.Thedifferenceswerestatisticallysignificant.Differencesofintraoperativeencephalocele,postoperativebasalcisternscores,ratesofpostoperativecomplicationsandprognosiswerestatisticallysignif
8、icant.Conclu
